Respiratory circuit with in vivo sterilization

ABSTRACT

A respirator comprise a breathing tube, such as an endotracheal tube, having a proximal end, a distal end, and a lumen extending between the proximal and distal end. The lumen defines at least a portion of the respirator circuit. A ventilator tube is in fluid communication with the proximal end of the breathing tube end and defines a portion of the respirator circuit. One or more light sources capable of emitting ultraviolet radiation irradiates at least a portion of the respirator circuit, thereby sterilizing the respiratory circuit.

This is a divisional application of Ser. No. 08/994,806 filed Dec. 19,1997, now U.S. Pat. No. 5,855,203.

TECHNICAL FIELD

The present invention relates generally to breathing devices, and willbe specifically disclosed as a respiratory circuit capable of in vivosterilization.

BACKGROUND OF THE INVENTION

In many medical situations, the pulmonary functions (i.e., relating tothe lungs) of a patient need to be monitored, controlled or accessed,and in many circumstances for days at a time. To achieve this, themedical field often uses a respiratory circuit which is connected to aventilator, which is sometimes referred to as a respirator. Typically,respiratory circuits include a breathing tube (e.g. endotracheal tubes,tracheostomy tubes, laryngeal mask airways, and the like) that acts asthe interface between the patient and the respiratory circuit. Forinstance, an endotracheal tube is inserted through the mouth or nasalpassages of the patient and into the trachea. Usually, a balloon or cuffsurrounding the inserted end of the tube is inflated to provide a sealbetween the endotracheal tube and the trachea. Once sealed, the patientbreathes through the endotracheal tube.

Once a breathing tube is connected to a patient, other components of therespiratory circuit are coupled to the breathing tube. Usually, aventilator tube links the breathing tube with a ventilator whichmonitors, and if necessary can control, the pulmonary functions of thepatient. Other components, such as junctions, moisture traps, filters,humidifiers and the like, optionally can be added to the respiratorycircuit. For instance, drug delivery systems can be added to therespiratory circuit to delivery aerosolized medicine to the lungs of thepatient. In some circumstances, medical care givers require access tothe lungs and/or trachea of the patient. For example, suction cathetersare used to remove secretions in a patient's lungs. In suchcircumstances, special junctions can be added to the respiratory circuitwhich allow such access without interrupting the monitoring or controlof the pulmonary functions.

An ongoing challenge with respiratory circuits is maintaining a sterileenvironment. Indeed, one clinical study has concluded that “trying tomaintain a sterile ventilator circuit for 24 hours is a difficult andperhaps impossible task.” Contaminated Condensate in MechanicalVentilator Circuits, Donald E. Craven, et al., Concise Clinical Study,p. 627. Due to the inherent moisture and warmth, respiratory circuitsprovide superb conditions for microbiological growth or colonization.Once colonization has started, the microbiological growth can easilyspread to the patient, either airborne or through moisture condensationrunning down into the patient's lungs, thus risking infections andcomplications, often resulting in pneumonia.

The problem of respiratory circuit colonization is especially prevalentwithin breathing tubes. For instance, studies has documented the healthrisks from colonization in endotracheal tubes, sometimes called abiofilm, which can be so extensive that the walls of the endotrachealtube become slimy and sticky. See Nosocomial pulmonary infection:Possible etiologic significance of bacterial adhesion to endotrachealtubes, Frank D. Sottile et al., Critical Care Medicine, Vol. 14, No. 4,p. 265. Due to the close proximity to the patient's lungs, anymicrobiological growth in a breathing tube can easily spread to thepatient's lungs. Condensed moisture can run down the breathing tube,over the biofilm and into the patient's lungs. Additionally, chunks ofthe biofilm can actually fall off the breathing tube and into thepatient's lungs.

SUMMARY OF THE INVENTION

Accordingly, an object of the invention is to provide an improvedrespirator circuit.

Another object of the invention is to provide a respirator circuitcapable of sterilization while connected to a patient.

Still another object of the present invention is to provide anendotracheal tube capable of in vivo sterilization.

Yet another object of the present invention is to provide a respiratorcircuit junction capable of vivo sterilization.

Additional objectives, advantages and novel features of the inventionwill be set forth in the description that follows and, in part, willbecome apparent to those skilled in the art upon examining or practicingthe invention. The objects and advantages of the invention may berealized and obtained by means of the instrumentalities and combinationsparticularly pointed out in the appended claims.

One aspect of the present invention is an apparatus for in vivosterilization of a respiratory circuit. A breathing tube has a proximalend, a distal end and a lumen extending between the proximal and distalends. The lumen defines at least a portion of a respiratory circuit. Aventilator tube is in fluid communication with the proximal end of thebreathing tube. The ventilator tube defines at least a portion of therespiratory circuit and has an inhalation portion and exhalationportion. One or more light sources irradiate at least a portion of therespiratory circuit. The light sources emit ultraviolet radiation forsterilizing the respiratory circuit.

Another aspect of the present invention is an endotracheal tube. A tubeis adapted for insertion into the trachea of a patient. The tube has aproximal end, a distal end, and a tube wall having an inner surface andan outer surface. A light source emits ultraviolet radiation. The lightsource is positioned relative to the tube to bathe at least a portion ofthe inner surface of the tube wall with ultraviolet radiation.

Still another aspect of the present invention is a respiratory circuitjunction. A tube port is adapted to interface with a breathing tube. Aline port is adapted to interface with a ventilator line. A flow pathextends between the tube and line ports. A catheter having a proximalend and a distal end is received by a catheter port connected to theflow path. The catheter port is dimensioned such that the catheter canbe axially moved relative to the catheter port. The catheter port isaligned relative to the tube port such that the distal end of thecatheter can be inserted into a breathing tube connected to the tubeport. A light source capable of emitting ultraviolet radiation ispositioned to irradiate at least a portion of the catheter.

Still other aspects of the present invention will become apparent tothose skilled in the art from the following description of a preferredembodiment, which is by way of illustration, one of the best modescontemplated for carrying out the invention. As will be realized, theinvention is capable of other different and obvious aspects, all withoutdeparting from the invention. Accordingly, the drawings and descriptionsare illustrative in nature and not restrictive.

BRIEF DESCRIPTION OF THE DRAWINGS

The accompanying drawings, incorporated in and forming part of thespecification, illustrate several aspects of the present invention and,together with their descriptions, serve to explain the principles of theinvention. In the drawings:

FIG. 1 depicts a schematic view of a respiratory circuit capable of invivo sterilization;

FIG. 2 depicts an endotracheal tube capable of in vivo sterilization;

FIG. 3 depicts an alternative embodiment of an endotracheal tube capableof in vivo sterilization;

FIG. 4 depicts another embodiment of an endotracheal tube capable of invivo sterilization;

FIG. 5 depicts yet another embodiment of an endotracheal tube capable ofin vivo sterilization;

FIG. 6 depicts still another embodiment of an endotracheal tube capableof in vivo sterilization;

FIG. 7 depicts a respiratory circuit junction with a suction cathetercapable of in vivo sterilization; and

FIG. 8 depicts a ventilator tube capable of in vivo sterilization.

Reference will now be made to the present preferred embodiment of theinvention, an example of which is illustrated in the accompanyingdrawings, wherein like numerals indicate the same element throughout theviews.

DETAILED DESCRIPTION

One embodiment of the present invention is depicted in FIG. 1, whichillustrates an example of a respiratory circuit 10. A breathing tube 20,shown here as an endotracheal tube, forms a portion of the respiratorycircuit 10. A ventilator tube 30 also forms a portion of the respiratorycircuit 10. The ventilator tube 30 includes an exhalation portion 31 andan inhalation portion 32. The ventilator tube 30 is connected to aventilator (not shown), which can be used to monitor and/or control thepulmonary functions of a patient. Valves and control mechanisms in theventilator direct whether the exhalation portion 31 or the inhalationportion 32 will be used during a breath cycle. The ventilator tube 30 isin fluid communication with the breathing tube through the junction 33.A variety of components are connected to the ventilator tube 30. Themoisture trap 34 is used to collect any condensation buildup in theventilator tube 30. A filter 35 is located within the flow passage ofthe ventilator tube 30 and is used to filter air passing through theinhalation portion 32. The humidifier 36 is used to add moisture to airin the inhalation portion 32.

One or more light sources 41-45 are positioned so as to irradiate atleast a portion of the respiratory circuit 10. The light sources canremain on at all times while the respiratory circuit is in use, oralternatively could be intermittently activated. The light sources emitultraviolet radiation which sterilizes those portions of the respiratorycircuit which are being irradiated as well as the air flowing in therespiratory circuit. Preferably, the light sources will emit lightranging from 200 to 400 nanometers in wave length. Ultraviolet radiationis capable of sterilizing both airborne and surface microbiologicalgrowth. For instance, studies have indicated that the sterilizationefficacy of ultraviolet radiation in standard air flow conditions (0.5second irradiation) were found to be over 99.5% in staphylococcusaureus, staphylococcus epidermidis, serratia marcescens, bacillussubtilis (vegetative cell) and bacillus subtilis (spore), and 67% inaspergillus niger (conidium). In aspergillus niger, which was the mostresilient microbe to ultraviolet radiation, the efficacy rose up to 79%when irradiated for one second.

Preferably, the light sources are strategically positioned in therespiratory circuit 10 so as to sterilize the most critical areas. Forinstance, the light source 41 is located in the exhalation portion 31 ofthe ventilator tube. The light source 42 is positioned so as toirradiate the Y junction between the exhalation portion 31 and theinhalation portion 32 within the ventilator tube 30. The light source 43is located so as to irradiate the junction 33 and so as to irradiate thelumen of the breathing tube 20. The light source 44 positioned so as toirradiate the moisture trap 34. The light source 45 irradiates thefilter 35 and the light source 46 irradiates the humidifier 36. Beyondthese respirator components, ultraviolet light sources can be positionedto irradiate other components, such as artificial noses, nebulizers,etc. As one with ordinary skill in the art will readily appreciate, moreor fewer light sources could be used to achieve the objectives of thepresent invention.

FIG. 2 illustrates an endotracheal tube 50 which may be used in place ofthe breathing tube 20. The endotracheal tube 50 comprises a tube wall51, which is connected to the interface 52 dimensioned to connect toother components of a ventilator circuit. The endotracheal tube has adistal end 53 and a proximal end 54 with a lumen 55 extending betweenthe proximal 54 and distal 53 ends. The cuff 59 is a balloon whichsurrounds the tube wall 51 near the distal end 53 to provide a seal oncethe endotracheal tube is inserted in the trachea of a patient. The cuffcan be inflated and deflated through a tube (not shown,) preferablylocated within the tube wall 51, with a device such as a syringe (notshown).

Preferably, when connected to the other parts of the respiratory circuit10, light source 43 is positioned so as to irradiate the proximal end 54such that ultraviolet radiation enters the lumen 55. A reflectiveportion 56 on the inner surface of the tube wall 51 reflects theultraviolet radiation that enters the lumen 55. The reflectiveproperties of the inner surface portion 56 can come from a coating oralternatively through a reflective composite within the tube wall 51.For instance, particulates of aluminum or silver can be suspended in thetube wall 51 to provide adequate reflective properties. When ultravioletradiation enters the lumen 55 and strikes the reflective portion 56, theultraviolet radiation will reflect and disperse within the lumen 55 andpropagate towards the distal end 53, thus bathing the inner surface ofthe tube wall 51 with ultraviolet radiation.

The ultraviolet absorbent portion 57 of the inner surface of the tubewall 51 will absorb substantial portions of the reflected ultravioletradiation, thus preventing ultraviolet radiation from exiting throughthe distal end 53. Like the reflective portion 56, the absorbent portion57 can be a coating or suspended within the tube wall 51. One suitablecomposition is graphite suspended within the tube wall 51. Preferably,the absorbent portion 57 will have a beveled interface 57A with thereflective portion 56 so as to control the amount of ultravioletradiation exiting the absorbent port 57 while minimizing the amount ofultraviolet radiation exiting the distal end 53. The amount ofultraviolet radiation leaving the distal and 53 can be furthercontrolled by intermittently activating the light source or controllingthe intensity of the light source so as to provide only the desiredresults.

As the ultraviolet radiation strikes the reflective portion 56 and theabsorbent portion 57, the inner surface of the tube wall 51 will besterilized, thus preventing colonization in the endotracheal tube 50.While the reflective portion 56 and the absorbent portion 57 arepreferably ultraviolet opaque (i.e., substantially impervious to thepassage of ultraviolet radiation), the outer surface 58 of the tube wall51 can optionally include an ultraviolet absorbing coating to furtherprevent any ultraviolet radiation within the lumen 55 from irradiatingthrough the tube wall 51 and striking the patient. The interface 52 alsopreferably has ultraviolet opaque qualities.

FIG. 3 depicts an alternative embodiment of an endotracheal tube 60. Theendotracheal tube includes an inner tube wall 61 and an outer tube wall63. The two tube walls 61, 63 are connected to the interface 64. Anultraviolet light source 65 is optically coupled with the interface 64,and the interface 64 is optically coupled with the inner tube wall 61.Both the interface 64 and the inner tube wall 61 are made from a lighttransmissive material such that radiation emanating from the lightsource 65 passes through the interface 64 and into the inner tube wall61. The inner tube wall 61 acts as an optical path for the ultravioletradiation. The outer tube wall 63, which can take the form of a coatingaround the inner tube wall 61, has ultraviolet opaque qualities suchthat light within the inner tube wall 61 will not irradiate through theouter tube wall 63 and strike the patient. Ultraviolet radiation withinthe inner tube wall 61 will illuminate the inner surface 67 therebysterilizing the endotracheal tube 60.

The portion 62 oft he inner tube wall 61 near the distal end 66 of theendotracheal tube 60 also has ultraviolet opaque qualities. As such,ultraviolet radiation traveling longitudinally along the inner tube wall61 will be prevented from traveling the entire length of the inner tubewall 61 and exiting the distal end 66. Any ultraviolet radiationirradiating from the inner tube wall 61 into the lumen 68 will strikethe absorptive portion 62 thus preventing ultraviolet radiation in thelumen 68 from exiting the distal end 66.

The amount of ultraviolet radiation entering the lumen 68 from the innertube wall 61 can be increased by adding particulates within the innertube wall 61. When the ultraviolet radiation traveling through theoptical path strikes these particulates, the light will be diffused andexit the inner tube wall 61 to strike the inner surface 67. Beyond theembodiment shown in FIG. 3, the light source 65 could be directlycoupled to the inner tube wall 61 thus bypassing the interface 64.Alternatively, discrete optical paths in the form of light fiberslocated in the inner tube wall 61 or adjacent the inner surface 67 couldbe used to sterilize the endotracheal tube.

FIG. 4 depicts another embodiment of an endotracheal tube capable of invivo sterilization. In one embodiment, the endotracheal tube 70 has atube wall 71 with ultraviolet opaque qualities. Preferably, the tubewall 71 is substantially absorbative to ultraviolet radiation, therebypreventing the propagation of ultraviolet radiation within theendotracheal tube 70. The light catheter 74 is coupled to a ultravioletradiation light source (not shown) and the catheter 74 is inserted inthe endotracheal tube. Preferably, ultraviolet radiation will onlyemanate from the distal tip 75 of the catheter 74, and ideally, only inthe proximal direction to prevent ultraviolet radiation from exiting thedistal end 72. Preferably, the length of the catheter 74 is limited soas to prevent the distal end 75 of the catheter from extending beyondthe distal end 72 of the endotracheal tube. Located near the distal end72 of the endotracheal tube is an optional ultraviolet radiation sensor73. The ultraviolet sensor 73 is an additional precaution to preventultraviolet radiation from exiting the distal end 72 of the endotrachealtube. When a predetermined amount of ultraviolet radiation strikes thesensor 73, a signal is sent to the proximal end (not shown) of theendotracheal tube and the light source is automatically turned off.

FIGS. 4A-4D illustrate several embodiments of the light catheter 74which can provide directional diffusion of ultraviolet radiation. All ofthe illustrated catheter embodiments share a light delivery fiber 76which is directly coupled to an ultraviolet light source (not shown).All the illustrated embodiments also share a catheter wall 77surrounding the fiber 76, which wall 77 is at least partiallytransparent adjacent the diffuser 78A-D. As shown in FIG. 4A,ultraviolet light traveling along the light delivery fiber 76 willstrike the cap diffuser 78A which will in turn reflect and diffuse thelight in the proximal direction. FIGS. 4B and 4C illustrate a concaveand convex embodiments of the reflective diffusers 78B and 78C,respectively, which are encased within the catheter wall 77. FIG. 4Dillustrates a diffuser 78D which is directly coupled with the lightdelivery fiber 76. Particles are embedded with in the diffuser 78D suchthat light will strike the particles and reflect away from the diffuser.A cap piece 79 prevents ultraviolet radiation from exiting the distalend 75 of the catheter 74.

The light catheter 74 is used by first inserting the distal end 75 intoa standard catheter port in a ventilator circuit. The light source isthen activated. The distal end 75 is then pushed down into theendotracheal tube 70 until it reaches close to the distal end 72. Then,the catheter is pulled out from the endotracheal tube in the reverseorder. As the distal end 75 is inserted and pulled from the tube 70, theultraviolet radiation will strike the inner surface of the tube wall 71thus sterilizing it and preventing colonization and the buildup ofbiofilm. This catheter sterilization process is performed periodicallywhile a patient is intubated. Preferably, the sterilization process willbe preformed once every hour. In another embodiment, the tube wall 71 isat least partially transparent such that the outer surface of the tubewall will be sterilized.

FIG. 5 depicts another embodiment of an endotracheal tube 80. Theendotracheal tube 80 comprises a tube wall 81 which is connected to theinterface 88. The interface 88 is connected to a junction 90 having acatheter port 91. When the endotracheal tube requires sterilization, thefilter probe 85 is inserted into the lumen 84, as shown. The filterprobe 85 has a filter 86 which allows air to pass through but blocksultraviolet radiation. The junction 90 further comprises a light source93 capable of emitting ultraviolet radiation, which is activated whenthe filter probe 85 is located in the endotracheal tube 80. The lightsource 93 is positioned such that the ultraviolet radiation willirradiate the lumen 84 of the endotracheal tube 80. The inner surface 82of the tube wall 81 is preferably reflective and opaque such that theultraviolet radiation will propagate towards the distal end 83 of theendotracheal tube, thus bathing the inner surface 82 with sterilizingultraviolet radiation. The filter 86 prevents ultraviolet radiation fromexiting through the distal end 83.

Preferably, the filter 86 is substantially air permeable and made from aresilient foam or fibrous material capable of being biased to the innersurface 82 of the endotracheal tube wall 81. Ideally, the filter 86 iscompressible enough to fit through the catheter port 91. Optionally, thefilter probe 85 includes a bar 87 or other blocking mechanism preventthe filter 86 from extending beyond the distal end 83. Preferably, thelight source 93 will only illuminate when the bar 87 engages the contact92 to complete an electrical circuit. As such, the light source 93automatically activates only when the probe 85 is fully inserted in theendotracheal tube 80. After the inner surface is sterilized, the probe85 is removed, thus deactivating the light source 93, and disposed. Thecatheter port 91 can then be capped.

FIG. 6 depicts another embodiment of an endotracheal tube 100. Theendotracheal tube 100 includes a tube wall 101. When the endotrachealtube requires sterilization, the inner tube 102 is inserted within thetube wall 101. The inner tube 102 includes a cuff 105 which wheninflated provides a seal between the inner tube 102 and the tube wall101. When the cuff 105 is inflated, the patient breathes through thelumen 103 of the inner tube 102, which extends between the vent holes106 and the open distal end 104 of the inner tube 102. In this position,the light source 109A, which emits ultraviolet radiation, irradiates theinner surface of the tube wall 101 thereby sterilizing the endotrachealtube. The outer surface of the inner tube 102 and/or the inner surfaceof the outer tube 101 are reflective and opaque to help propagateultraviolet radiation within the endotracheal tube. The cuff 105 isopaque and prevents ultraviolet radiation from exiting the distal end ofthe endotracheal tube. Optionally, the junction 107 is adapted forreceiving the inner tube 102 and includes a sleeve 108 to maintain theinner tube 102 in the sterile environment when not inserted within thetube wall 101. The junction 107 also includes the light source 109Bwhich is positioned so as to irradiate the inner tube 102 as it isinserted and removed from the tube wall 101.

FIG. 7 depicts a junction 110 in a respiratory circuit. The junction 110includes a tube port 112, which is adapted to receive a breathing tube120, such as an endotracheal tube. The junction 110 includes two lineports 113A and 113B which are adapted to receive various components fora respiratory circuit. For instance the line port 113A is connected to aventilator line 122 and the line port 113B is connected to a cap 124.Other such attachments include metered dose inhalers, swivel couplings,and the like. The catheter port 114 receives the catheter 115 and isdimensioned such that the catheter can move axially relative to thecatheter port 114, as demonstrated in phantom. The catheter port 114 isaligned relative to the breathing tube 120 such that the catheter 115can be inserted into the breathing tube 120. In this embodiment,catheter 115 is a suction catheter which is adapted to be inserted intothe breathing tube 120 and into the patient's lungs to remove secretionsor fluid. The tip 116 of the catheter 115 includes several openings toallow such suction.

In its fully retracted position, as shown in FIG. 7, the catheter 115 isstored in a flexible sleeve 117, which maintains the catheter 115 in thesterile environment while not being use. The light sources 118A-D arecapable of emitting ultraviolet radiation. The light sources 118A and118B are positioned adjacent the catheter port 114 to irradiate thecatheter 115. As such, when the catheter 115 is inserted into orretracted from the breathing tube 120, a substantial length of theinserted catheter 115 will be irradiated with ultraviolet radiation thussterilizing it. Preferably, the catheter 115 is at least partiallytransparent so the ultraviolet radiation will sterilize both the outersurface and the inner surface of the catheter 115. The light sources118C and 118D are positioned so as to irradiate the inner surface 111 ofthe junction 110 and also to irradiate the lumen of the breathing tube120. Preferably the wall 110 of the junction is opaque, except where thelight sources 118A-D are located. In this embodiment, the inner surface111 is reflective so as to encourage the propagation and bathing of theinner surface 111 with ultraviolet radiation.

FIG. 8A depicts a portion of a ventilator line 130. The flexibleportions 131 are integrally connected to the cylindrical portion 132.The ventilator tube wall, including both the flexible portion 131 andthe cylindrical portion 132, is ultraviolet opaque which preventsultraviolet radiation from escaping through the walls. Preferably, thetube wall is reflective to encourage the propagation of ultravioletradiation along the ventilator tube. The window 133, however, doespermit ultraviolet radiation from passing through. As depicted in FIG.8B, the window 133 is adapted to receive a light source 135 capable ofemitting ultraviolet radiation. When not in use, the tape 134, which iscapable of blocking ultraviolet radiation, covers the window 133 thuspreventing ultraviolet radiation within the tube from escaping throughthe window 133. The tape 134 can also be used to secure the light source135 to the cylindrical portion 132. Other windows can be locatedthroughout the ventilator tube wherever sterilization is desired.Similar variations of the embodiment illustrated in FIG. 8 can be easilyadapted to sterilized various components within the respirator circuit,such as moisture traps, filters, humidifiers, and the like.

Throughout the foregoing specification, the materials used in thejunctions, ventilator tubes, breathing tubes, etc. are designed to beirradiated with ultraviolet radiation, which can be destructive to manymaterials. As such, preferred materials will be resistant to ultravioletradiation, either through their inherence qualities, such as Teflon, orthrough additives used as ultraviolet absorbers or antioxidants. Whileone with ordinary skill in the art will be capable of selecting suchpreferred materials or additives, the following references maybehelpful: Polymer Degradation Principles and Practical Applications by W.Schnabel, Polymer Chemistry and Introduction Second Edition by MalcolmP. Stevens, New Linear Polymers by Henry Lee, et al., and PlasticComponent Design by Paul Campbell, which references are herebyincorporated by reference.

The foregoing description of the preferred embodiment of the inventionhas been presented for purposes of illustration and description. It isnot intended to be exhaustive nor to limit the invention to the preciseform disclosed. Many alternatives, modifications, and variations will beapparent to those skilled in the art in light of the above teaching.Accordingly, this invention is intended to embrace all alternatives,modifications, and variations that fall within the spirit and broadscope of the amended claims.

We claim:
 1. A respiratory circuit junction, comprising: a) a tube portadapted to interface with a breathing tube; b) a line port adapted tointerface with a ventilator line; c) a flow path extending between thetube and line ports; d) a catheter having a proximal end and a distalend; e) a catheter port connected to the flow path for receiving thecatheter such that the catheter can be axially moved relative to thecatheter port, said catheter port being aligned relative to the tubeport such that the distal end of the catheter can be inserted into abreathing tube connected to the tube port; f) a light source positionedto irradiate at least a portion of the catheter, said light source beingcapable of emitting ultraviolet radiation; and g) an ultraviolet opaqueportion operative to absorb ultraviolet radiation within the respiratorycircuit junction to prevent a substantial portion of ultravioletradiation from exiting the junction and striking a patient.
 2. Arespiratory circuit junction as recited in claim 1, wherein the catheteris a suction tube.
 3. A respiratory circuit junction as recited in claim1, wherein the light source is located adjacent the catheter port.
 4. Arespiratory circuit junction as recited in claim 1, wherein at least aportion of the inner surface of the respiratory circuit junction isreflective to ultraviolet light.
 5. A respiratory circuit junction asrecited in claim 1, wherein one or more light sources are locatedadjacent to the line port.
 6. A respiratory circuit junction as recitedin claim 1, further comprising an additional line port.
 7. A respiratorycircuit junction as recited in claim 6, wherein one or more lightsources are located adjacent to the additional line port.
 8. Arespiratory circuit junction as recited in claim 6, further comprising ametered dose inhaler unit coupled to the additional line port.
 9. Arespiratory circuit junction as recited in claim 6, further comprising aswivel coupling coupled to the additional line port.
 10. A respiratorycircuit junction as recited in claim 6, further comprising an opticalpath located in the flow path extending between the tube and line ports,wherein said light source is optically connected to said optical path.11. A respiratory circuit junction as recited in claim 10, wherein thelight source irradiates through the respiratory circuit junction towardsthe breathing tube.
 12. A method for in vivo sterilization of arespiratory circuit unction, comprising the steps of: a) inserting abreathing tube in the trachea of a patient; b) connecting a respiratorycircuit junction to the breathing tube, said respiratory circuitjunction having an inner surface defining a flow path and a catheterport with a catheter positioned therein; c) irradiating at least aportion of the inner surface of the respiratory circuit junction withultraviolet radiation to sterilize the inner surface while therespiratory circuit junction is connected to the breathing tube; and d)absorbing the ultraviolet radiation to prevent a substantial portion ofradiation from leaving the respiratory circuit junction and striking thepatient.
 13. A method of in vivo sterilization of a respiratory circuitjunction as recited in claim 12, wherein the step of irradiating isperformed intermittently.
 14. A method of in vivo sterilization of arespiratory circuit junction as recited in claim 12, wherein the step ofirradiating comprises positioning an ultraviolet light source externalto the respiratory circuit junction and bathing the inner surface withultraviolet radiation from the light source.
 15. A method of in vivosterilization of a respiratory circuit junction as recited in claim 12,further comprising the step of connecting the respiratory circuitjunction to a metered dose inhaler unit.
 16. A method of in vivosterilization of a respiratory circuit junction as recited in claim 12,further comprising the step of connecting the respiratory circuitjunction to a swivel coupling.
 17. A respiratory circuit junction,comprising: a) a tube port in fluid communication with a breathing tube;b) a line port in fluid communication with a ventilator line; c) a meansfor inserting and retracting a catheter into and out of the breathingtube; d) a means for irradiating at least a portion of the catheter withultraviolet radiation to sterilize the catheter while the breathing tubeis connected to a patient; and e) a means for absorbing the ultravioletradiation to prevent a substantial portion of radiation from leaving therespiratory circuit junction and striking the patient.
 18. A respiratorycircuit junction as recited in claim 17, further comprising a means forirradiating at least a portion of the inner surface of the respiratorycircuit junction to sterilize the inner surface.
 19. A respiratorycircuit junction as recited in claim 17, further comprising anadditional line port.
 20. A respiratory circuit junction as recited inclaim 19, further comprising one or more light sources located adjacentto the additional port.